Multi-media medical record system

ABSTRACT

Disclosed is a method of processing data that includes image data, video data, or image and video data pertaining to a medical procedure. The method includes using a computer system to receive a video identification indicative of at least one of an imaging device and a video capture device that is to be a source of the data captured during the medical procedure. A patient identification indicative of an identity of a patient to be treated during the medical procedure is received with the computer system. The data transmitted by the at least one of the imaging device and the video capture device is received with the computer system, and is received without the identity of the patient. A relationship is established to link the data with the identification of the patient. Application of at least one processing rule is initiated to reduce a file size of the data from an original file size of the data as transmitted by the at least one of the imaging device and the video capture device. The data is stored in combination with the identification of the patient in a manner compliant with a standardized medical imaging transmission format.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of application Ser. No. 13/270,124,filed on Oct. 10, 2011, which claims the benefit of U.S. ProvisionalApplication No. 61/391,503, filed Oct. 8, 2010, each of which isincorporated in its entirety herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This application relates generally to a method and apparatus for storingmedical data and, more specifically, to a storage server and method forcombining video data with medical records, and more specifically, tomethods that optionally reduce the size of the video data and route themedical records containing video data, either manually or automatically,to a desired storage destination other than the storage server, andprovide an interface to remotely access and view the medical records.

2. Description of Related Art

Conventional methods and apparatuses for storing medically relatedvideos use analog media such as magnetic tapes or standalone digitalvideo capture devices that are not integrated into healthcare EMR(Electronic Medical Record) systems and storage systems. Withconventional systems, videos are usually stored on a single piece ofremovable media or one storage device that is not a part of the EMRsystem. This limits the ability to share video data with otherhealthcare professionals and increases the risk that videos will be lostor deleted. Additionally, videos from conventional systems are usuallysaved in a consumer file format such as MPEG that is not compatible withhealthcare storage systems called PACS systems. MPEG files must beconverted to a different format called DICOM that is a medical standardfor encoding and transferring image, video and other data types withinhealthcare organizations. Once a video is converted to the DICOMstandard, it can be transferred to a PACS system for long-term storage.While the DICOM standard defines support for videos, most PACS systemsdo not fully support video data. PACS systems are typically limited totransferring patient records containing video data in and out of thesystem. Most PACS systems also lack adequate storage and storagemanagement for handling the large size of video data and are unable toview videos on DICOM display terminals that are primarily intended forimage viewing. The challenge is to provide a solution that leveragesexisting healthcare IT (Information Technology) data networks andequipment that were not specifically designed to store and displaymedical records containing video data.

BRIEF SUMMARY

According to one aspect, the subject application involves a method ofprocessing data that includes image data, video data, or image and videodata pertaining to a medical procedure. The method includes using acomputer system to receive a video identification indicative of at leastone of an imaging device and a video capture device that is to be asource of the data captured during the medical procedure. A patientidentification indicative of an identity of a patient to be treatedduring the medical procedure is received with the computer system. Thedata transmitted by the at least one of the imaging device and the videocapture device is received with the computer system, and is receivedwithout the identity of the patient. A relationship is established tolink the data with the identification of the patient. Application of atleast one processing rule is initiated to reduce a file size of the datafrom an original file size of the data as transmitted by the at leastone of the imaging device and the video capture device. The data isstored in combination with the identification of the patient in a mannercompliant with a standardized medical imaging transmission format.

According to another aspect, the subject application involves a methodof capturing data including image data, video data, or image and videodata pertaining to a medical procedure. A computer system is used toreceive a video identification indicative of a video capture device thatis to capture the data during a medical procedure. With the computersystem, a patient identification indicative of a patient to be treatedduring the medical procedure is also received. Information istransmitted over a communication network for establishing the patientidentification at the video capture device that is to capture the data,thereby allowing the video capture device to associate the patientidentification with the data. The method also includes receiving thedata associated with the patient identification transmitted by the videocapture device, and storing, in a computer-accessible memory, the dataassociated with the patient identification transmitted by the videocapture device. A subsequent request for the data from thecomputer-accessible memory returns the data in combination with thepatient identification.

According to another aspect, the subject application involves a methodof processing data including image data, video data, or image and videodata pertaining to a medical procedure. The method includes using acomputer system, receiving the data in a standardized medical imagetransmission format. The standardized medical imagining transmissionformat includes a patient identification in combination with the data.Application of at least one processing rule is initiated to reduce afile size of the data combined with the patient identification from anoriginal file size of the data as received by the computer system.

The above summary presents a simplified summary in order to provide abasic understanding of some aspects of the systems and/or methodsdiscussed herein. This summary is not an extensive overview of thesystems and/or methods discussed herein. It is not intended to identifykey/critical elements or to delineate the scope of such systems and/ormethods. Its sole purpose is to present some concepts in a simplifiedform as a prelude to the more detailed description that is presentedlater.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention may take physical form in certain parts and arrangement ofparts, embodiments of which will be described in detail in thisspecification and illustrated in the accompanying drawings which form apart hereof and wherein:

FIG. 1 is an illustrative embodiment of a computer system including aplurality of cameras for capturing video data to be received by astorage server and optionally processed for storage PACS or transmissionover a communication network and/or for being displayed;

FIG. 2 is a flow diagram schematically illustrating a method of applyinga rule to image data; and

FIG. 3 is a flow diagram schematically illustrating a method ofprocessing data including image data, video data, or a combinationthereof.

DETAILED DESCRIPTION

Certain terminology is used herein for convenience only and is not to betaken as a limitation on the present invention. Relative language usedherein is best understood with reference to the drawings, in which likenumerals are used to identify like or similar items. Further, in thedrawings, certain features may be shown in somewhat schematic form.

It is also to be noted that the phrase “at least one of”, if usedherein, followed by a plurality of members herein means one of themembers, or a combination of more than one of the members. For example,the phrase “at least one of a first widget and a second widget” means inthe present application: the first widget, the second widget, or thefirst widget and the second widget. Likewise, “at least one of a firstwidget, a second widget and a third widget” means in the presentapplication: the first widget, the second widget, the third widget, thefirst widget and the second widget, the first widget and the thirdwidget, the second widget and the third widget, or the first widget andthe second widget and the third widget.

A fully integrated digital medical video solution efficiently captures,identifies, stores, distributes and views video data as a part ofpatient healthcare records. This includes associating videos with thecorrect patient, physician and procedure identification information,compressing the size of the video data to accommodate the limitations ofexisting healthcare storage systems, limiting the bandwidth requirementsfor transferring and playback of videos to accommodate the capacity ofexisting data networks, and transmitting videos in a format that iscompatible with viewing software on existing display terminals inhealthcare environments. Access to patient medical records that includevideo are also managed in a way that complies with patient privacyguidelines without being a significant burden to healthcare personnel.

FIG. 1 shows an illustrative embodiment of a healthcare IT communicationnetwork 22 that can include a restricted, internal network for usewithin the healthcare organization, an external network such as theInternet, or a combination thereof. The network 22 operatively connectsservers and other networkable devices including at least one EMR(Electronic Medical Record system) 330 that stores and provides patientidentification information and stores patient healthcare records, atleast one PACS (Picture Archiving and Communication System) 360 thatstores and retrieves medical images and videos in standardized medicalimaging transmission format, such as a format compliant with the DigitalImaging and Communications in Medicine (“DICOM”) standard, at least oneLDAP (Lightweight Directory Access Protocol server) 361 that stores andtransmits clinician identification information, at least one storageserver 14 that stores, assembles, processes, converts and manages videosand/or images, at least one operating room 300 with a plurality of videocapture devices 380 for capturing and optionally recording videos andimages from one or more video cameras 318 and medical scopes 334(generally “imaging devices”) containing video cameras, and at least oneviewing station 340 that reproduces videos and images to be displayed tomedical personnel. PACS 360 can optionally be dedicated for storing suchdata in the standardized format for subsequent retrieval over thenetwork 22.

Each video capture device 380 can include a hard disk drive, flashmemory, analog recording tape or other suitable non-transitorycomputer-readable medium on which data comprising video, image or videoand image data captured by a camera 318, medical scope 334, or otherconnected imagining device is stored. A computer processor provided tothe video capture device 380 can execute computer-executable logic tocapture the video and/or image data as described herein. At thebeginning of a medical procedure, the video capture device(s) 380 can beutilized to obtain patient identification information from a patientcensus database on the storage server 14. The patient census databasestored by the storage server 14 can optionally be created and updated bymonitoring admit-discharge-transfer (“ADT”) codes transmitted from theEMR 330 over the network 22 to the storage server 14 as described inU.S. Provisional Patent Application Ser. No. 61/264,784. ADT codes aresimple codes that are entered into the system in response to theprogression of a patient through treatment. The ADT codes can optionallybe transmitted over the network 22 each time they are updated in the EMR330, periodically, or at any desired interval. According to alternateembodiments, the ADT codes stored by the EMR 330 can be queried by queryrequests submitted by the storage server 14. Regardless of how such ADTcodes are used to create and update the patient census database, a firstcode is entered for each patient when the patient is admitted to ahealthcare facility, and a second code is entered into the EMR 330 whenthe patient is discharged. A plurality of different codes are alsoentered into the EMR 330 for a patient at various stages of treatmentbetween admission and discharge, such as when a patient is transferredbetween departments, offices, healthcare facilities, treating physiciansor other personnel, etc. . . . . ADT codes can optionally beautomatically, without user intervention, entered over the network 22 inresponse to a triggering event such as transmission of a signal by anautomated medical modality, for example. For other embodiments, the ADTcodes can be entered over the network 22 manually, by personnel at thehealthcare facility when certain milestones are reached over the courseof treatment.

Regardless of how it is entered into the server 14, the patientinformation can optionally be provided to the video capture device 380in response to a request submitted by the video capture device. Thequery request can optionally be initiated by a clinician using aninterface on the video capture device 380. For example, one or morequery requests, including but not limited to DICOM Modality Work Listlook up of patient information in the patient census database stored bythe storage server 14, and proprietary search methods involvingcommunications over the network 22 that allow a clinician to look uppatient information in patient census on the storage server 14 using aninterface on the video capture device 380 can be submitted to thestorage server 14. These proprietary search techniques can be specificto certain models of video capture devices. The DICOM Modality Worklist,for example, is a standardized and defined DICOM-compliant query routineperformed by medical modalities such as medical imaging equipment, videocapture device, and other hardware typically encountered in healthcarefacilities for example. The query utilizes a standard C-FIND search forpatient demographic and study details over the network 22. By automatingthe query performed by a medical modality typing and other manual-entrymistakes can be minimized.

In response to submitting the query request to the server 14, the server14 transmits a subset of patients satisfying the query request stored inthe storage server 14 to the video capture device. For example, theclinician can specify via the user interface provided to the videocapture device 380 that the patient's last name begins with the letter“B” and this information can be transmitted over the network 22 to besubmitted as part of the query request to the server 14. In response toreceiving such a query request, the server 14 can transmit all patientshaving a last name that begins with the letter “B.” This subset ofpatient information transmitted to the video capture device 380 can bedisplayed to the clinician via a display device provided to the userinterface, for example, as a list the clinician can scroll through tolocate the proper patient that will be the subject of the medicalprocedure. Once the correct patient identification information has beenconfirmed by the clinician using the video capture device 380, theinformation is maintained on the video capture device 380 during theprocedure and sent to the storage server 14 along with videos and/orimages to ensure the correct patient is associated with the videos andimages.

Although search and selection of patient identification information iscommonly performed by a clinician using the interface provided on manyvideo capture devices 380 as mentioned above, an alternate method foridentifying the patient information and combining it with videos andimages is described in U.S. Provisional Patent Application Ser. No.61/264,784, which is incorporated herein in its entirety by reference.The alternate method allows a clinician to use a data terminal includedin the computer system operatively connected via network 22 or othernetworked computer to connect to storage server 14 and search thenselect the patient identification information on the storage server 14.The clinician also selects the video capture device 380 from a set ofvideo capture devices known to the storage server 14. The storage server14 has been configured with a set of known video capture devices and theassociated network addresses. The storage server 14 can then use thenetwork address of the video capture device 380 to associate the patientinformation with the videos and images. Additionally, the set of knownvideo capture devices 380 can be configured on the storage server 14with a symbolic name such as OR1 or ENDOSCOPY SUITE 2B that can be usedto identify the specific video capture device 380. This method ofpatient information lookup and selection allows the video capture device380 to send videos and images that do not contain any identifyingpatient information data or incomplete/inaccurate patient identificationinformation to the storage server 14 where the software executed by thestorage server 14 uses network address or symbolic name of the videocapture device 380 to associate the patient information with the videosand images.

In alternate embodiments, patient information identification can beassigned by a clinician using a data computer terminal connected to thenetwork 22 or other networked computer to connect to storage server 14to search and select the patient identification information on thestorage server 14. The clinician also selects the video capture device380 from a set of video capture devices known to the storage server 14.The storage server 14 has been configured with a set of known videocapture devices and an associated shared network folder name, sometimescalled a “watch folder” for each known video capture device that will besending videos and images. Additionally, the set of known video capturedevices 380 and their associated shared network folders can beconfigured on the storage server 14 with a symbolic name such as ORSUITE 3A or ENDOSCOPY ROOM 1 that can be used to identify the specificvideo capture device 380 that will be sending the videos and images.Once the patient information is assigned by the clinician, the videocapture device 380 stores videos and images into the shared networkfolder that is configured on the storage server 14 for that videocapture device 380. The storage server 14 uses the shared network folderto associate the patient information with the videos and images.According to each of the embodiments, a relationship is establishedbetween the selected video capture device(s) 380 and the selectedpatient information so that the data captured by the video capturedevice 380 is stored in association with the selected patientinformation. Once stored, the patient information can be integrated withthe captured data in a manner that makes the patient informationinseparable from the captured data. According to alternate embodiments,the captured data can be stored with the patient information in a mannercompliant with the DICOM standard.

Another aspect of the invention relates to assigning the identificationinformation of the physician (e.g. full name, network username or emailaddress) performing the procedure to the medical record containingvideos and images. Rather than manual, typed entry of a physician'sname, the physician's name is selected directly from a database ofphysicians stored on an LDAP 361 server on the network 22 who areauthorized to treat patients at the healthcare facility. The LDAP 361 isaccessible using the video capture device 380 or other computer terminalvia the network 22. This will provide an authoritative source ofinformation. The LDAP 361 server may optionally store a database of allusers authorized to access the network 22 rather than, or in addition tothe names of authorized physicians. The information in the LDAP 361server can include the full name, network login username and emailaddress of authorized personnel. Access to information contained on theLDAP 361 server usually requires those accessing the LDAP 361 to enter ausername and password, thereby uniquely identifying those who log in.The storage server 14 can also be assigned a username and password toaccess the LDAP 361 server for the purpose of searching for physicianinformation or other user information that may be retrieved forinclusion in medical records. The storage server 14 can optionallyautomatically log into the LDAP 361 server over the network 22 using theusername and password assigned to the storage server 14 and provide aninterface for a clinician using a data terminal, network computer orviewing station 340 on the same network 22 to search for a physician orother user on the LDAP 361 server. Once the desired physician or user isfound and selected, the clinician selects the video capture device 380from a set of video capture devices known to the storage server 14. Thestorage server 14 has been configured with a set of known video capturedevices 380 and the associated network addresses. The storage server 14uses the network address of the video capture device 380 to associatethe physician information with the videos and images. Additionally, theset of known video capture devices 380 can be configured on the storageserver 14 with a symbolic name such as OR1 or ENDOSCOPY SUITE 2B thatcan be used to identify the specific video capture device 380. Thismethod of physician information lookup and selection allows the videocapture device 380 to send videos and images that do not containphysician identifying information to the storage server 14 where thesoftware on the storage server 14 uses network address or symbolic nameof the video capture device 380 to associate the physician informationwith the videos and images.

In alternate embodiments, physician identification can be assigned by aclinician using a data computer terminal on the network 22 or networkedcomputer to connect to storage server 14 to search and select thephysician information on the storage server 14. The storage server 14will be configured with a username and password to access the LDAP 361server for the purpose of searching for a physician or other users thatmay be required for medical records. The storage server 14 canautomatically log into the LDAP 361 server over the network 22,optionally in the background and out of view of the clinician, andprovide an interface for a clinician using a data terminal on thenetwork 22 or networked computer or viewing station 340 to search for aphysician or other user on the LDAP 361 server. Once the desiredphysician or user is found and selected, the clinician selects the videocapture device 380 from a set of video capture devices known to thestorage server 14. The storage server 14 has been configured with a setof known video capture devices and an associated shared network foldername, also known as a “watch folder”, for each known video capturedevice that will be sending videos and images. Additionally, the set ofknown video capture devices 380 and their associated shared networkfolders can be configured on the storage server 14 with a symbolic namesuch as OR SUITE 3A or ENDOSCOPY ROOM 1 that can be used to identify thespecific video capture device 380 that will be sending the videos andimages. Once the physician information is assigned by the clinician, thevideo capture device 380 stores videos and images into the sharednetwork folder that is configured on the storage server 14 for thatvideo capture device 380. The storage server 14 uses the shared networkfolder to associate the physician information with the videos andimages.

As videos and images are transferred from the video capture devices 380to the storage server 14 over the network 22, the videos and images areoptionally processed according to rules 372 that are stored by thestorage server 14. When so configured, multiple rules 372 can be appliedto any given video, image or patient record on the storage server 14.Rules 372 can also be applied at different times in the processing forinformation. For example, some rules 372 may apply to video files arethey are received in watch folders while other rules 372 are applied toconverter the videos to patient records in DICOM format or transferpatient records of the network 22 to other systems such as PACS 360servers. The rules 372 can optionally govern a method of compressing thesize of captured video data and route predetermined video data tovarious long-term storage destinations such as PACS 360.

Data produced from modern video capture devices 380 that are connectedto high definition video sources from cameras 318 and scopes 334 canexceed 15 GB of data storage per hour of video. Many healthcarefacilities lack sufficient storage requirements for long-term archivingof large videos on PACS 360 servers. Compressing videos using automatic,rule based processing is a convenient method of managing the datastorage requirements without burdening healthcare professionals withmanual editing or compressing of videos.

One application of the rules 372 configured on storage server 14 is toallow each healthcare facility to define specific video “transcoding”settings based on the characteristics of the video received from thevideo capture device 380 or videos contained in patient records receivedfrom other sources such as PACS 360. Transcoding can be used to reducethe size of videos from the size captured by the video capture device380 by decoding the source video into individual frames, then encodingthose frames with new settings that generally include lower resolutions,lower bit rates, lower frame rates and improved compression algorithms.The rules 372 in the storage server 14 allow a single source video to betranscoded into multiple videos of reduced size. This is often desirablesince different applications require different resolutions. For example,a physician preparing a presentation for a medical conference of a newsurgery technique may want a high resolution video to show exceptionaldetail. A surgeon reviewing a surgery at home by retrieving video of thesurgery stored in the PACS 360, storage server 14 or othernetwork-accessible computer-readable medium over a DSL line with limitedbandwidth, for example, may need a lower resolution and lower bit rateto avoid delays caused by the slower DSL network speed. A facility canconfigure any number of video transcoding rules 372 on the storageserver 14, but a typical high definition video that is 1080p (1920×1080resolution, 30 frames/second, 15Mbits/second) will get transcoded to twoor three smaller sizes including medium resolution of 480p (720×480resolution, 30 frames/second, 2.5Mbits/second) which is similar to DVDquality and a low resolution of 240p (360×240 resolution, 15frames/second, 0.7Mbits/second). In addition to changing the resolution,frame rate and bit rate, the rules 372 allow a different videocompression technique to be used. This is commonly called an “encoding”.MPEG2 is a popular video encoding method found in consumer andcommercial applications that was used in many first or second generationmedical video capture devices 380. New encoding techniques such as H.264can reduce storage requirements by up to 25% of the original MPEG2 datasize without a visually-noticeable change in video quality. The storageserver 14 includes several video encoders 371 that can be combined withother settings including resolution, frame rate and bit rate in therules 372.

Another method used to reduce the data storage requirements of a videois to eliminate parts of the video that have little or no clinicalsignificance. For example, in some surgical procedures, only a fewminutes of a one hour video may be considered important enough toarchive. Having a simple, automatic method to identify the importantsections of video can greatly reduce storage requirements. One method toaccomplish this is to use a “marker” that is placed by the surgeon as areference point to make a video clip around. The video capture device(s)380 can include a foot pedal or thumb switch connected to a scope 334,for example, that is used by the surgeon to capture an image fordocumentation purposes during the procedure. These images typicallyinclude a time index that indicates the time in the video that the imagewas captured. A rule 372 can be configured on the storage server 14 thatextracts a video clip from the corresponding video using a sitespecified number of seconds before the image time index and a differentsetting for the number of seconds after the image time index to use whenextracting the video clip. Both the “before” and “after” configurabletime settings are a part of the rule 372. For example, if an image wascaptured by the surgeon 30 minutes into a procedure and the storageserver 14 had a rule configured to extract 120 seconds before the imageand 60 seconds after the image, a clip of 3 minutes would be create bythe storage server 14 by extracting video from time index 28 minutes totime index 31 minutes.

Another method to reduce the data storage requirements of videos is tomanually extract clips from a video. Given the large size of somevideos, it is impractical to move or manipulate a high-resolution videoacross a network. In this case, a rule 372 can be created on the storageserver 14 to automatically generate a low-resolution video from theoriginal high-resolution video on the storage server 14. In anotheraspect of the invention, a user accesses the storage server 14 from aviewing station 340 using a web interface or other graphical applicationon the viewing station over the network 22 to view the low-resolutionvideo and create a list of start time and end time indexes that are usedby the storage server to extract clips from the high resolution video.Alternately, a frame count index can be used instead of the time indexto correlate the position in a low resolution video with the sameapproximate position in the high resolution video. In this way, the useris not burdened by the problems associated with viewing ahigh-resolution video, but can still accomplish the goal of extractinghigh-resolution clips using a low-resolution version of the video whichis easier to view and navigate remotely.

In another embodiment of the invention that relates to video clips,rules 372 can be created on the storage server 14 that apply the sametime indexes generated from automatic or manual video clipping, to beused for extracting clips from other videos of the same patient record.This allows video clips of a significant event to be generated frommultiple points of reference using different cameras 318 or scopes 334that were all captured at the same time in the same procedure.

Rules 372 can also be used to determine which videos and images will betransferred from the storage server 14 to other medical storage devicessuch as a PACS 360. One common application is to create a rule 372 thatonly transfers a specific resolution of any video to the PACS. Forexample, a rule 372 can be created that specifies to only transfer the480p resolution of a video to the PACS. Rules 372 can also includepatient, physician and/or procedure information in the decision makingprocess when determining what medical records are selected for transferor other operations. For example, a particular surgeon may want alltheir automatically generated video clips and images from gall bladdersurgeries to be saved to PACS 360.

Rules 372 can be created to determine how long a video of a particularresolution, frame rate or bit rate will be saved on the storage server14. Different rules 372 can be created for different time frames. Forexample, a rule can be set up on storage server 14 to delete all 1080phigh resolution videos immediately after transcoding to lowerresolutions 480p and 240p. A second rule 372 can be created on the samestorage server 14 to delete all 480p videos 60 days after the last timethey were viewed over the network 22 from a viewing station 340. Rules372 can also include patient, physician and/or procedure information inthe decision making process when determining what medical records areselected for deletion or other operations

Multiple rules 372 can be created on the same storage server 14, thatwork in combination to increase their usefulness and power. There is nolimit to the number of rules 372 that can be created on the same storageserver 14. For example, a rule 372 can be created to transcode allvideos to 480p. A second rule 372 can be created move all 480p videos onstorage server 14 to a PACS 360. A third rule can be created to removethe 480p videos from the storage server 14, ninety days after the lasttime they were viewed over the network 22 from a viewing station 340.

Another aspect of the invention is the ability to capture and saveindividual images from a video. These images are sometimes called “stillcaptures” or “still capture images”. The purpose is to allow a user tocreate a set of one or more images that can be used for documentation inthe patient healthcare record, verification of a procedure or event forbilling purposes, education and training of new medical personnel, or asa tool for collaboration between medical professionals. Creating a stillcapture image after the procedure is complete, is sometimes necessarywhen some or all of the required still images were not captured by thesurgeon at the time of the procedure using the foot pedal or thumbbutton on the scope 334. Creating still images from a video starts witha user logging into a storage server 14 from a viewing station 340 overthe network 22. Using a graphical interface, such as a web interface,the user selects a video to be used for capturing still images. Giventhe large size of some videos, it is often impractical to move ormanipulate a high-resolution video across a network. In this case, arule 372 can be created on the storage server 14 to automaticallygenerate a low-resolution video from the original high-resolution videoon the storage server 14. The user can view the low-resolution videofrom the viewing station 340 and identify an area of interest in thevideo. The graphical interface for viewing the video on the viewingstation 340 can include a “scrub bar”, “fast forward”, “fast backward”,“single frame step”, “multi-frame step”, or other such interface elementthat allows the user move forward or backward through the video tolocate an area of interest. Another method to locate an area of interestis to place graphical markers that represent previous still captureimages as visual markers on the graphical interface. This featuretypically uses the time index of the image, relative to the video it wascaptured from, to put visual marks that are placed on the scrub bar orother video timeline displayed on the graphics interface so the user cansee the approximate position within the video that the image was createdor extracted. For example, if a video is one hour in length and a stillcapture image was made from that video with a relative time index of 30minutes from the start of the video, then a visual mark would appear inthe middle of the scrub bar or timeline which is 50% of the way throughthe video. Using visual markers of previous still images can be a usefulaid to quickly navigate through a video. Once an area of interest islocated, the user can use controls on the graphical interface to finetune the frame to be captured by moving the through the video using“single frame step forward”, “single frame step backwards”, “multi-framestep forward”, “multi-frame step backward” or other such interfaceelements that allow the user move forward or backward through the videowith greater precision than a scrub bar. Since the user is viewing a lowresolution version of the video that was transcoded from ahigh-resolution video on the storage server 14, the level of detailrequired to correctly select a still capture image may not be visiblefrom the low resolution video. To compensate for this, the storageserver 14 includes software that uses the time index or frame countindex of the low resolution video frame the user is viewing to extractthe closest corresponding frame from the high resolution video as aseparate image. The high resolution image is then displayed on thegraphical interface of viewing station 340 so the user can see a greaterlevel of detail and determine if the image should be captured and savedas part of the procedure. Each time the user navigates to a new videoframe on the low resolution version, a corresponding high-resolutionimage is extracted from the high-resolution video on the storage server14 and displayed on the viewing station 340.

In another embodiment of the invention, multiple storage servers 14 canbe combined on the same network 22 to transparently aggregate theoperation of the servers from the perspective of the user. When multiplestorage servers 14 are aggregated together, the servers can shareinformation related to patient records and optionally, othercapabilities such as resources related to data storage, processor, jobqueues, workload, etc. A user can connect to any storage server 14 inthe aggregation set from a viewing station 340. When the initialconnection is made, the user will be presented with a login screen fromthe specified storage server 14. For purposes of simplifying thisdescription, the storage server 14 that the user chose to log into willbe called the “master server” and the other servers in the aggregationset will be called “remote servers”. When a search for patient recordsis initiated by the user on the master server, the master server willnotify all remote servers in the aggregation set over the network 22 tosearch for patient records using the same search parameters. Resultsfrom each remote server are received by the master server over thenetwork 22 and the results are combined by the master server anddisplayed to the user on the viewing station 340. When the user selectsa patient record, the master server will process the request locally ifthe patient record is on the master server, or pass control to theremote server that is storing the selected patient record. There aremultiple methods to pass control to a remote server, including but notlimited to, creating a URL, also known as a network link, containing thenetwork address of the remote server and a unique indentifyinginformation string for the patient record that the user selected on theviewing station 340 to transfer control to the remote server containingthe patient record. The URL can also contain optional securityinformation that is encoded into the URL string to prevent unauthorizedusers from accessing the storage server 14 with the same URL link fromother computers on the network 22. The security information can use oneor more methods to safeguard the storage server 14 including, but notlimited to, the use of a timestamp, the use of a one-time access code,the use of a private/public key, and the encoding of uniqueidentification information for the view station 340.

The method mentioned above for transferring control from a master serverto a remote server can also be adapted to provide a method for a viewingstation 340 to view a video stored in a patient record on a PACS 360.Many viewing stations 340 include DICOM image viewing software,sometimes called a DICOM viewer, that are not capable of viewing videoscontained in DICOM patient records. Many PACS 360 servers can store andtransfer DICOM patient record containing videos, but cannot extract thevideos and provide a method to view them on a viewing station 340 thathas a DICOM viewer without video viewing capabilities. This problem canbe solved by providing an intermediary system, such as the storageserver 14, that can retrieve a DICOM patient record containing a videofrom the PACS 360 and extract and send the video from the patient recordto the viewing station 340 that has a video viewer installed that doesnot require a DICOM viewer. One method of accomplishing thisfunctionality involves either the PACS 360 system or the viewing station340 executing computer-executable instructions to create a URL, alsoknown as a network link, with the network address of the storage server14 and unique indentifying information for the patient record on thePACS 360. The URL can also contain optional encoded security informationthat prevents unauthorized users from accessing the storage server 14with a URL link from other computers on the network 22. The securityinformation can use one or more methods to safeguard the information onthe storage server 14 including, but not limited to, the use of atimestamp, the use of a one-time access code, the use of aprivate/public key, and the encoding of unique identificationinformation for the view station 340. The URL is presented to the userby the viewing station 340. The URL may not be directly visible to theuser and may be “hidden” behind a graphical icon or other text messagethat is selected by the user. When the user selects the URL, eitherdirectly or indirectly, a web browser is launched on the viewing station340 that transfers control to the storage server 14. When the URL isreceived by the storage server 14 and validated as authentic using theencoded security information, the storage server 14 retrieves thepatient record from the PACS 360 using the unique patient recordidentifying information encoded in the URL and extracts the video data.The storage server 14 then sends the video data over the network 22 to avideo viewing program on the viewing station 340. The video data canoptionally be sent to the viewing station 340 using a secured networkconnection that employs an encryption technique to prevent unauthorized“ease dropping” on the video or other data being exchanged between thedevices on the network 22. This technique permits a user to watch avideo contained in a DICOM patient record when neither the PACS 360 northe viewing station 340 is configured with software that can extract andplay the video contained in the DICOM patient record.

The method described above for viewing videos contained in patientrecords on PACS 360 systems using a viewing station 340 can besimplified and used for viewing videos stored on the storage server 14.One such method involves having the storage server 14 incorporate a webserver that is accessed from viewing station 340 over the network 22.After a user logs into the storage server 14 and selects a patientrecord contained on the system, the system can extract the video fromthe patient record if the patient record is in DICOM format, or directlyaccess the video in the case where the video is a standalone file thatis in not encapsulated in DICOM format. Accessing the video directly isan optimization that can reduce the amount of processing and timerequired to start playing the video. Once the storage server 14 hasaccess to the video data, it sends the video data over the network 22 toa video viewing program on the viewing station 340. This techniquepermits a user to watch a video contained on the storage server 14. Thevideo data can optionally be sent to the viewing station 340 using asecured network connection that employs an encryption technique toprotect against unauthorized “eavse dropping” on the video or other databeing exchanged between the devices on the network 22.

Video and image data contained in patient records on the storage server14 can be downloaded by users on viewing stations 340 or other computersystems connected to the network 22. After the user logs into thestorage server 14 from a viewing station 340 over the network 22, theuser can select a patient study for downloading. The storage server 14will extract the videos and images from the patient record, which istypically in medical format such as DICOM, and convert them to a commonfile format for more convenient use after the download is complete. Theuser will be presented with an interface on the viewing station 340 toselect the specific video and image files to be downloaded and commonfile format to be used. Typical common file formats include, but are notlimited to MPEG, AVI, WMV for videos and JPEG, BMP, PNG for images. Auser option to download the files in Microsoft® PowerPoint® format willoptionally be provided that combines all the images and videos selectedby the user for downloading into a single file. The user can optionallyspecify that the images and videos are to be scaled to a same resolutionfor more convenient viewing after they are downloaded. Alternately, theuser can chose to select a common “packaged” filed format such as ZIP,RAR, TAR or other formats that allow multiple files to be encapsulatedin a single file for easier downloading.

To further reduce the size of video and other data delivered to the PACSsystem at a given time, a predetermined set of rules can be applied tosuch data as it is received in a designated temporary storage folder inwhich video data is received for each local storage or on the storageserver 14 or en route to the PACS 360 system or another DICOM device onthe network 22. This temporary storage folder is accessible over a LAN,WAN, or a combination thereof, and is referred to as a “watch folder”373 that is provided to the storage server 14. With reference to FIG. 2,the contents of the watch folder 373 are monitored for any changes atstep 100. As the video data from the video capture device 380occasionally arrives in the watch folder 373 at step 110, such atriggering event is detected at step 120. Detection of the triggeringevent can result in the automatic, and without user intervention,application of video-specific rules governing the management of videodata received in the watch file 373 at step 130. The video-specificrules that can be applied to the video files in the watch folder 373include, but are not limited to, at least one of: cutting, clipping,compressing (also known as transcoding) and deleting the video data.

Cutting the video data, as the name suggests, refers to deletingunwanted or irrelevant video data altogether. Clipping, refers toextracting and saving the portions of video data that are of interestand deleting the other, unwanted portions of the video data. Andcompressing refers to reducing the video one or more aspects of thevideo data including the resolution, frame rate, bit rate, encodingmethod to make the overall size of the video data smaller than it wasoriginally.

When a storage server 14 is configured with video-specific rules 372,the application of the video-specific rules 372 typically results inless video data remaining in the watch folder 373 relative to the amountof data that was present before application of the rules. The video datathat remains is converted according to DICOM rules at step 140 using theDICOM converter 370 in the storage server 14 into DICOM-compliant videodata, and the DICOM-compliant video data is subsequently subjected torouting-specific rules and transmitted for storage in the PACS system orother intended storage destination at step 150.

The DICOM converter 370 can also convert image files received in thewatch folder 373 into DICOM-compliant format and incorporate the imagesinto the appropriate patient record.

To reduce the amount of time a user must wait for the storage server 14to process a large video, the watch folder 373 can receive segments ofvideo file. Each segment is processed after it is received according tothe video-specific rules 372. After each segment is processed, it issaved until the last segment is received. When the last segment isreceived and processed, the complete video is assembled from thesegments. The storage server 14 then processes the complete video thesame as any other video. This technique reduces the amount of time auser must wait for a video to be ready for use.

An illustrative method of processing data such as image data, videodata, or image and video data pertaining to a medical procedure isschematically illustrated in FIG. 3. The method includes receiving avideo identification indicative of at least one of an imaging device anda video capture device that is to be a source of the data capturedduring the medical procedure at step 305. For the sake of brevity, videoidentification is to be received by the video capture device 380, andthe data is to be received from the imaging device. However, it is to beunderstood that a networked computer terminal provided to the computersystem can optionally execute computer-executable instructions toperform the method herein rather than the video capture device 380 ofthe computer system. Thus, the video capture device can optionallycombine the patient information with the data as part of the process ofpreparing a DICOM or other standard-compliant data to be transmitted forstorage in an enterprise storage location such as PACS 360. Alternateembodiments involve receiving the data from the video capture device 380with such a computer terminal to be subsequently combined with thepatient data. However for the present example, the method describedbelow involves combining the data and patient information at the videocapture device 380, to be subsequently stored in an enterprise storagesolution such as PACS 360, and/or displayed to the clinician.

A patient identification indicative of an identity of a patient to betreated during the medical procedure is received at step 315. Asdescribed above, the patient identification can be selected from a listof patients, optionally a subset of patients satisfying a searchcriterion for example, via a user interface provided to the videocapture device 380. The data transmitted by the imaging device is alsoreceived at step 325 by the video capture device 380 and optionallystored, at least temporarily, thereon. The data transmitted by, andreceived from the imaging device lacks (i.e., is without) the identityof the patient. In other words, the data can optionally be raw data suchas that transmitted by a conventional video camera, for example.

A relationship is established at step 335, linking the data with theidentification of the patient received by the video capture device 380.The relationship can be any association connecting the data to thepatient. For example, the patient identification can be combined withthe data such that, once the combination is stored, subsequentlyretrieving the data necessarily retrieves the patient identification. Inother words, the patient identification is combined with the data suchthat the identification of the patient becomes a part of the data andcannot be inadvertently separated from the data when stored in acomputer-accessible memory. According to alternate embodiments, thepatient identification can be included in a header of the data, orotherwise combined in a manner compliant with the DICOM standard.

At least one processing rule can be initiated at step 345, reducing afile size of the data from an original file size of the data transmittedby the imaging device and/or video capture device. For example,transcoding the data can be initiated as a processing rule. The data canbe transmitted at step 355 for: storage in combination with theidentification of the patient in a manner compliant with a standardizedmedical imaging transmission format on a PACS 360 or other enterprisestorage solution, being displayed by a display device, or a combinationthereof.

Illustrative embodiments have been described, hereinabove. It will beapparent to those skilled in the art that the above devices and methodsmay incorporate changes and modifications without departing from thegeneral scope of this invention. It is intended to include all suchmodifications and alterations within the scope of the present invention.Furthermore, to the extent that the term “includes” is used in eitherthe detailed description or the claims, such term is intended to beinclusive in a manner similar to the term “comprising” as “comprising”is interpreted when employed as a transitional word in a claim.

What is claimed is:
 1. A method of processing data comprising imagedata, video data, or image and video data pertaining to a medicalprocedure, the method comprising: using a computer system, receiving avideo identification indicative of at least one of an imaging device anda video capture device that is to be a source of the data capturedduring the medical procedure that is to be processed; with the computersystem, receiving a patient identification indicative of an identity ofa patient to be treated during the medical procedure; with the computersystem, receiving the data transmitted by the at least one of theimaging device and the video capture device, wherein the data isreceived without the identity of the patient; establishing arelationship that links the data with the identification of the patient;initiating application of at least one processing rule that, whencomplete, reduces a file size of the data from an original file size ofthe data as transmitted by the at least one of the imaging device andthe video capture device; and storing the data in combination with theidentification of the patient in a manner compliant with a standardizedmedical imaging transmission format.
 2. The method of claim 1 furthercomprising storing, in a computer-accessible memory, the data capturedby the at least one of the imaging device and the video capture devicerelated to the patient identification.
 3. The method of claim 1, whereinsaid receiving said patient identification comprises: receiving a queryrequest for said patient identification from the video capture deviceover a communication network; and searching a database of electronicmedical records of patients for said patient identification satisfyingsaid query request.
 4. The method of claim 1, wherein said establishingthe relationship comprises: receiving an identity of a target folder inwhich the data captured by the video capture device is to be at leasttemporarily stored; and assigning the patient identification to the datastored in the target folder.
 5. The method of claim 1, wherein thepatient identification is combined with the data such that theidentification of the patient becomes a part of the data and can not beinadvertently separated from the data when stored in thecomputer-accessible memory.
 6. The method of claim 1 further comprisingstoring, in a computer-accessible memory, the data transmitted by the atleast one of the imagining device and the video capture device with therelationship so a subsequent request for the data from thecomputer-accessible memory returns the data in combination with theidentification of the patient.
 7. The method of claim 1, wherein thestandardized medical image transmission format is a DICOM standard. 8.The method of claim 1, wherein said receiving the patient identificationcomprises: transmitting, over a communication network, a subset ofpatients registered at a healthcare facility for presentation to a user;receiving, over the communication network, a specific patient selectedby the user from the subset; and establishing the identity of thepatient as the specific patient selected by the user.
 9. The method ofclaim 8, wherein said transmitting comprises transmitting the list ofpatients to the video capture device over the communication network. 10.A method of capturing data comprising image data, video data, or imageand video data pertaining to a medical procedure, the method comprising:using a computer system, receiving a video identification indicative ofa video capture device that is to capture the data during a medicalprocedure; with the computer system, receiving a patient identificationindicative of a patient to be treated during the medical procedure;transmitting information over a communication network for establishingthe patient identification at the video capture device that is tocapture the data, thereby allowing the video capture device to associatethe patient identification with the data; with the computer system,receiving the data associated with the patient identificationtransmitted by the video capture device; and storing in acomputer-accessible memory, the data associated with the patientidentification transmitted by the video capture device, wherein asubsequent request for the data from the computer-accessible memoryreturns the data in combination with the patient identification.
 11. Themethod of claim 10, wherein the data associated with the patientidentification by the video capture device is stored in thecomputer-accessible memory in a format that is compliant with astandardized medical image transmission format.
 12. The method of claim11, wherein the standardized medical image transmission format is aDICOM standard.
 13. The method of claim 10 further comprising initiatingapplication of at least one processing rule that, when complete, reducesa file size of the data from a captured file size of the data ascaptured by the video capture device.
 14. The method of claim 13,wherein the at least one rule applied comprises transcoding at least aportion of the data.
 15. A method of processing data comprising imagedata, video data, or image and video data pertaining to a medicalprocedure, the method comprising: using a computer system, receiving thedata in a standardized medical image transmission format, wherein thestandardized medical imagining transmission format comprises a patientidentification in combination with the data; and with the computersystem, initiating application of at least one processing rule that,when complete, reduces a file size of the data combined with the patientidentification from an original file size of the data as received by thecomputer system.